Cardiac heterogeneity in patients with chronic urticaria; A perusal of P wave and QT dispersions

Data on how the heart is affected in Chronic Urticaria (CU), a common annoying chronic dermatological disease, is quite limited. The electrocardiographic parameters; P wave dispersion (PWD) and QT dispersion (QTD) have been consistently reported to be predictive for cardiac arrhythmias and morbidity. We aimed to detect asymptomatic cardiovascular involvement in terms of predisposition to arrhythmias in chronic urticaria. This cross-sectional study included 128 individuals: 64 with CU and 64 healthy controls. 12-lead surface electrocardiogram and Doppler echocardiography were performed on patients and controls. All of the cardiologic parameters such as P wave, PWD, QTD and corrected QTD (QTDc) parameters were obtained from ECG measurements. Maximum P wave duration and PWD were found to be higher in CU patients than controls (P= 0.035 and P<0.001, resp). There were significant correlations between CU duration and PWD (r = 0.348, P = 0.005) and between Urticaria Activity Score and QTD and QTDc (r = 0.351, P = 0.004 and r = 0.361, P = 0.003 resp). Multiple linear regression analysis showed that; systolic blood pressure and CU duration are independently associated with PWD (β =0.344, p=0.003 and β=0.375, p=0.001 resp) and also that; diastolic blood pressure and disease activity (UAS7) are independently associated with both QTD (β=0.320, p=0.006 and β=0.377, p=0.001 resp) and QTDc (β=0.344, p=0.003 and β=0.389, p=0.001 resp). In patients suffering from Chronic Urticaria, PWD and QTD were significantly increased as compared to control group of healthy individuals. PWD was associated with disease duration while QTD and QTDc was associated with the disease activity.

Keywords: Arrhythmia, chronic urticaria, P wave dispersion, QT dispersion